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Home My WebLink AboutSAM-06-2016-073228.TIF 4?7,A Co Casey SAM-06-2016-073228 Lc al $ G� CATAWBA COUNTY HEALTH DEPARTMENT < pVIIMITI 6,0 1, Environmental Health Section "- 842 sM 06/07/2016 WATER SAMPLE APPLICATION Applicant WILLIE AMMONS, 2864 HOPIWFI I-CHURCH RD, SHERRILLS FORD NC 28673 H:828-228-1006C4DAl389aAOL.COM —` t Site Address: 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC SELECTED SAMPLES 28673 Bacterial Name of Subdivision: Parcel Number: 460801157164 Lot: 5 Block: Specific Directions Description: Reason for Sample:refinance home loan Type of Well lialinifeWiTi■IfIllin Is the well on this same property? ,Yes_1!y11 Is outside spigot available to collect sample? Yes`-"" Is power on? Igliliksa Has well been tested before? Yes��Gl"� Results Pos_tive1Colifbliiis=51247,16I 11 21511111011101E10 Nifel Does the plumbing cone out the top of the well through a sanitary well seal? ElriknoTiall Does the well ever become cloudy or has there ever been a problem with taste and/or odor? E'" "Noll Hl Explain Does the well top extend twelve (12) inches above the ground or well slab? 40. Yes'ININ The well is in: 1111Mb HisiPtSitiaillin 11 Does this well supply water to more than one home? RP I wog fflli Water samples will be drawn from an outside faucet unless otherwise specified. Please note that all water samples are taken during one visit. The processing laboratories have different protocols and timeframes for reporting results; therefore, you may receive several different reports concerning your water sample. For questions or more information, please contact Catawba County Environmental Health at(828)465-8270. Li I — Date ��. Signature or Owner or Agent ,IQ�� Area 1 �FEESF11 E DESCR` TIvu N Ij , ,rt�.p l!jf iIil1t RI ' ' I f lfl'DATE I?' �'1''FEE AMOIUNT� CRIPTIONf�� I � � ! _ _: m�� ----,IV Bacteriological Sample Fee 06/07/2016 858.00 II"1[i 11ITOTAFEES, ''''77.:*:: ', si!� llIIIl I-AillN�IflilliN 5OO ?' #Is '' IDWi111121li•LEILIIIIIMI In a,➢ ,r ^rNu11111 u4!'LT.IINLIIIJd11111Ea' . 1-Val132111i1'1': rsamapplication 6/7/2016 Page 1 of 2 ..rmtForm' cATA, '1-., :: Catawba County Public Health ' . i COUNTY www.catawbacountync.gov/environmentalhealth Environmental Health North Coronno P.O. Box 389, 100-A South West Blvd., Newton,NC 28658 Phone (828)465-8270. Fax(828) 465-8276 ��//�� Water Sample Application �c/� ��y /� Sample Requested��By��J`i1k1r`IZ i`Crne i�r l.� Home Phone i— & -!DU ,Property ddressia§ L ►{op\AkOiI C✓lU-✓C Pa.Business Phone < � m1 n- �/G ��Ma lingSSAddres Q((� I[ O X% ' Ciiu`._(�c^Ar 4 . �s0I (5 J'� c' V1 ' C. 31 /3 Driving Directions C l ' �' CCY" (5-P rat 11 • pi/n(50.-4k t (,A hopeAiw al c,h ua''c h Sample Requested: Bacteriological Inorganic Chemical _Other Sample reason: ► ep,nattnCC Y lQVh4 teeter) Type of Well: Drilled V Bored /Dug Other Is the well on this same property? Yes No Is outside spigot available to collect sam))e? Yes / No Is power on? Yes I/ No Has well been tested before? Yes No Unknown Results c l td 68q it(Q/ Does the plumbing come out the top of the well through a sanitary well seal? Yes No Unknown ' Does the water ever become cloudy or has there ever been a problem with taste or odor? Yes No V Explain Does the well top extend 12 inches above the ground or well slab? Yes! No Unknown The well is located in front rear left side right side V of the house. > Does well supply water to more than one home? Yes No L. �Date O0(.0 la) 1 lO Signature of Owner or Agent a • • • A "Leading the Way to a Healthier Community" ZPPar bHc -a. ,,` °Health yA CATAWBA COUNTY 0� IOOA SOUTHWEST BLVD �� M NEWTON, NORTH CAROLINA 28658 ¢ . ,,,,..five RECEIPT iIP PA . H PHONE: 828.465.8399 ti Tuesday, June 7, 2016 U 9 ''C \842. SM www.catawbacountync.gov PAYOR: Ammons, Willie PAYMENTS TRANSACTION NUMBER: TRC-687599-07-06-2016 PAYMENT DATE : 06/07/2016 PAYMENT TYPE: Cash INVOICE NUMBER FEE NAME FEE AMOUNT 06-16-329158 Bacteriological Sample Fee 558.00 TOTAL PAYMENTS : $58.00 SAM-06-2016-073228 CASE TYPE: Water Sample WORK CLASS: Bacterial SITE ADDRESS: 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 Applicant WILLIE AMMONS, 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 H:828-228-1006 **NO PEOPLESOFT ACCOUNT ASSIGNED ** receipt 06/07/2016 15:51 Page I of 1 $A C case a SAM-06-2016-073228 CATAWBA COUNTY HEALTH DEPARTMENT Environmental Health Section 1842 sM 06/14/2016 WATER SAMPLE FIELD REPORT Applicant WILLIE AMMONS, 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 H:828-228-1006 MDA1389 @AOL.COM Site Address: 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 460801157164 Lot: 5 Block: Specific Directions At the corner of Mt Pleasant Road & Hopewell Church Rd Initial Collected by: i 70-v/7 p Date/Time Sampled: VIC//‘ /- 9 Pm / m Type of Sampling Point: (141/ ke ci e/ Well New or Existing? New Existing Type of Well: Drilled )( Bored Dug Spring City Does well meet adequate construction standards from what can be observed: X Yes No Reason for non-compliance: Defective well cap and /or seal Piping does not exit through top of well by approved cap and sanitary well seal Evidence of improper grouting or no grouting Opening in the well casing or cap Supply too close to source of potential contamination Notification: Existing well owner notified that well does not meet adequate construction ? Yes No Date of Notice: E9 - rsamfieldreport 6/14/2016 Page 1 of 2 A C,'� case ti SAM-06-2016-073228 �' 'C: 4 G'2 CATAWBA COUNTY HEALTH DEPARTMENT a i► gi `� Em ironmental Health Section U +ves: C 141 sm j84'L sM 06/14/2016 WATER SAMPLE TEST RESULTS Applicant WILLIE AMMONS, 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 H:828-228-1006 MDAI389aAOL.COM Site Address: 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 Name of Project: Parcel Number: 460801157164 Lot: 5 Block: Lab Coliform Analysis Results: Total Coliforms: prt/'vn" Fecal / E. Coll: G + No Collection Date Over 30 hours old Invalid Results: Excessive turbidity Excessive Chlorine Lab Accident /�� q � Lab Tech Initials VH Date/Time Received ODI\ \iI U ICAO Date/Time Completed Q DI�SJ ILO I UW "Pt RECEIVED JUN 16 2016 CATAWBA COUNTY ENVIRONMENTAL HEALTH E9 - rsamfieldreport 6/14/2016 Page 2 of 2 North Carolina Division of Public Health Occupational and Environmental Epidemiology Branch, Epidemiology Section BIOLOGICAL ANALYSIS REPORT Private well water information and recommendations County: Catawba Name: Willie Ammons Sample ID Number: 73228 Location: 2864 Hopewell Church Rd. Shen-ills Ford. NC 28673 Reviewer: M. Cash Initial Sample: X Confirmation Sample BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR PRIVATE WELL WAFER (These recommendations are based on biological analysis only.) No coliform bacteria were found in your well water. Your water can be used for all purposes including drinking, cooking, washing dishes, bathing and showering. X Total coliform bacteria were detected in the sample which indicates that harmful bacteria from human or animal waste could enter the well. Do not use the water for drinking or cooking unless it has been boiled for 3 minutes. You may use your water for all other purposes including washing dishes, bathing or showering. Your well water needs to be re-tested to verify that the result is accurate. Fecal coliform bacteria were detected in the sample. Do not use the water for drinking, cooking, washing dishes, bathing or showering. If the re-test shows contamination by bacteria contact your local health department for assistance. There may be a problem with the construction of the well, the groundwater source, or operation of the well. The well needs to be inspected by the local health department or a local well contractor to determine the problem with the well and to give guidance on how to correct the problem. Your well water was tested for biological contaminants (total coliform and fecal coliform bacteria). The results were evaluated using the federal drinking water standards. Drinking water may contain substances that can occur naturally in water or can be introduced into water from man-made sources. Total coliform bacteria are found in soil and fecal coliform bacteria are found in animal and human waste. Total coliform or fecal coliform bacteria in well water indicate that the well may have structural problems or that the well was not properly disinfected. If you have been drinking the well water and are pregnant, nursing; have a child in the household under 5 years of age, or immunocompromised (such as an individual with AIDS, cancer, hepatitis, dialysis or surgical procedures) inform your physician of these results at your next visit. If the contamination continues, you should investigate the possibility of drilling a new well or installing a point-of-entry disinfection unit which can use chlorine, ultraviolet light, or ozone. For further information please contact your county health department or the Occupational and Environmental Epidemiology Branch at 919-707-5900. Ia CATAWBA COUNTY U --r (� t +.� P O Box 389 -Newton, North Carolina 28658 -(828)465-8270 - Fax(828)465-8276-TDD(828)465-8200 � �'"t"` Public Health - Environmental Health Division 1842 sM WILLIE AMMONS 6/17/2016 2864 HOPEWELL CHURCH RD SHERRILLS FORD NC 28673 REPORT OF WATER ANALYSIS & CONDITION OF SUPPLY Property Address: 2864 HOPEWELL CHURCH RD, SHERRILLS FORD NC 28673 WATER ANALYSIS This certifies that a sample of drinking water was taken from the above address on 06/14/16 and examined under laboratory number SAM-06-2016-073228. Laboratory findings reveal that this sample was potentially unsafe and should not be used unless boiled or otherwise disinfected. Steps need to be taken to correct the condition of your water supply. CONDITION OF SUPPLY Your water supply was observed to MEET adequate construction standards (in regards to well head protection). NOTES *The results of any water analysis only reflects the quality of the water at the time of the sampling. If you have any questions concerning your water sample analysis, please call me at the number bel Mike Cash (828)320-3067 Environmental Health Specialist ;6,lM Cnao�ti `r . B f'oeaa, csl1I I 1,� I s i'� "Keeping the Spirit Alive Since 1842!" GREATER ,,/ HICKORY °a?4 ni P�.�p✓ METRO E9-rsamwatersampleletter 6/17/2016 Page 1 of 1